Posted by Brigham and Women's Hospital October 16, 2012

The multidisciplinary Advanced Heart Disease team meets weekly to thoroughly evaluate treatment options for every patient.

Many people with heart disease can successfully manage their condition with medications and lifestyle adjustments. But, for a relative few with very advanced heart disease, their only option is a heart transplant.

Because donor hearts are scarce, only about two thousand heart transplants are performed in the United States each year, leaving thousands of people across the nation on a wait list for a heart transplant. Additionally, many people with advanced heart disease are considered ineligible for heart transplant due to older age or other medical conditions.

Today, advanced heart disease specialists are using newer devices, like left ventricular assist devices (LVADs), as a temporary or long-term alternative to heart transplantation. These devices are accessible at major medical centers and often provide a viable therapy option for patients ineligible for heart transplant.

For patients with biventricular heart failure (affecting both sides of the heart), one of the newest options – a total artificial heart – can support the patient until a donor heart can be found. Earlier this year, a team of cardiovascular specialists at BWH, led by Dr. Gregory Couper, performed the first total artificial heart implant in New England.

“People who receive these devices earlier are stronger going into the procedure and have fewer complications after they receive the device,” explains Dr. Mandeep Mehra, Executive Director of the Center for Advanced Heart Disease at Brigham and Women’s Hospital (BWH). “We also are finding that their outcomes more closely match those seen among people who have undergone heart transplants.”

“There is a lot we can do, but it’s important that people with advanced heart disease receive specialized evaluation and care as soon as possible, when the most options are available for them,” says Dr. Michael Givertz, Medical Director of the Heart Transplant and Mechanical Circulatory Support Program.

So, when is the best time to consider going to an advanced heart disease specialist?

“Generally, when people are feeling unwell most of the time, have experienced hospitalizations and declining kidney function related to heart disease, and become increasingly resistant or intolerant of their heart medications, it is time to see an advanced heart disease specialist,” says Dr. Mehra. “Also, people with a complex condition, like amyloidosis,familial or genetically determined cardiac disease, heart disease resulting from chemotherapy or radiation, congenital heart disease, or severe right heart failure should be evaluated early and treated in collaboration with a center specializing in advanced heart disease.”

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